Pregnancy can be a wonderful time of hope and excitement while awaiting your newest family member. It can also be a time of uncertainty, especially where your employment is concerned. Some employers have positive attitudes and policies regarding maternity leave and parenting, while other employers have a less than welcoming approach. The good news is that there are laws to protect pregnant women and most employers fall somewhere in the middle of the extremes.

Often, telling our boss that we are pregnant can be the biggest stress hurdle. Here are some helpful tips to help you tell your employer that you are pregnant:

1. Know your rights. Read your company’s policy on maternity leave and parental leave and familiarize yourself with the federal Family and Medical Leave Act (FMLA) and state laws regarding maternity leave. The U.S. does not have paid maternity leave laws. California is one of only four states that have paid maternity leave laws in addition to FMLA. It might tip your hand to ask HR for the company’s maternity leave policies. You should be able to access company policies in your initial employment paperwork, by requesting a copy of the employee handbook/policy manual from HR, or it may be in an employee online portal.

2. When to tell. Many women wait until they are into the second trimester (four to six months) before telling an employer of their pregnancy. Often, this is when women begin to “show” but it is also considered a “safe” time since most miscarriages occur in the first trimester (three months) of a pregnancy. Some women have such severe morning sickness that they may need to share the news with their employer early in their pregnancy as it could become a medical issue impacting their performance.

Consider timing your announcement until after an upcoming performance review, project deadline or deal. Telling your supervisor before a pending company reorganization could be mutually beneficial if you don’t plan on returning after the baby is born. It could be a good time to part ways and possibly leave with a severance package or unemployment benefits instead of just quitting after the baby is born. Conversely, if you plan to return after the baby is born, you might consider holding off on sharing your pregnancy news. Employers are not legally permitted to fire you for being pregnant but they can let you go under the guise of the reorganization.

3. Who to tell. Often, co-workers are close friends so women are most likely share their pregnancy news with them first – or with social media. However, it would be best to share your pregnancy news with your direct supervisor or human resources first. Which leads us to best practices on how to tell your employer you are pregnant.

4. How to tell. Face-to-face is the best way to tell your employer. This enables you to gauge her reaction and give you an insight into how she and/or the company may feel about pregnant employees, maternity leave, and accommodating working parents. If you are concerned about your direct supervisor’s reaction, consider sharing the news with HR first or requesting a meeting with HR, you and your supervisor.

5. What to say. The initial announcement should be brief to share that you are pregnant and the baby’s due date. Don’t overshare about the details – save those for your personal friends over lunch or dinner. You may want to assure your employer that you have given this much thought but all of the logistics (like this maternity leave plan) can be worked out in the coming months. Don’t lock yourself into any promises or commitments early on (i.e. Do not say: “I plan to work right up until my due date,” or, “I will only need six weeks off.”) because you won’t know details until you and your doctor discuss your medical needs in the coming months.

6. Email Follow Up. It’s always good to have an electronic record of the date and nature of your conversation. The face-to-face should be followed up with a simple email the same day: “Susan, Thanks for your time today so I could share my pregnancy announcement with you. The baby’s due date is… I look forward to working out the logistics for my leave in the coming months.”

With a little advance planning, telling your boss that you are pregnant can be a simple and positive experience. If you are pregnant and unsure of your pregnancy decision, the client advocates at Support Circle can listen and help you make a decision that is in line with your values. We can also help prepare for your conversation with your employer by helping you to talk it through and role play.

To schedule an appointment at one of our three Bay Area clinics, call 888-252-1822 or visit: supportcircle.org/today.

Support Circle has been fortunate to work with women in an unintended pregnancy who choose adoption as their final pregnancy decision. We have found this population of women to be courageous, selfless and extremely contemplative about their decision. As I reflect upon several women who chose to place their child for adoption, and the complexity of issues that they addressed during their pregnancies and the level of support they received throughout the decision-making process. I am also struck by the various profiles and personal histories of the women and men who chose adoption for their pregnancy option.

Consider Jennifer and Mike, a young couple from the mid-west who traveled to the west coast seeking greater employment opportunities after graduating high school. They discovered the pregnancy six months into their journey to California and came to our clinic to confirm how far along the pregnancy was by ultrasound and to discuss their pregnancy options. At ages 19 and 20, Jennifer and Mike were honest and transparent about their life in California, their limited support system (in the mid-west and the Bay Area) and their prospects for college education and an apprenticeship program in California. They had no family and very few friends in California and while the lack of support from friends was very bleak for them, returning to the mid-west was less appealing.

And then there was Jane, a 40-year-old, single mother of one child who came to our clinic at seven months and chose adoption because her physical and financial health could not sustain another child. Jane wrestled with her decision and expressed feelings of guilt, resentment, anger and depression because her eight-year-old daughter was old enough to understand “where babies come from” but could not figure out why her mother was going to deny her an opportunity to have a little brother or little sister. Our partnership with various adoption agencies, attorneys, and services in the Bay Area assisted Jane and her daughter with a healthy adoption plan and family counseling to help them for the remaining weeks of the pregnancy and during the transition and placement.

Lastly, there was Remi, a 28-year-old single mother and active leader in her church. Remi was devastated to learn of her pregnancy after living an abstinent life since the birth of her 6-year-old son. She met Dave, a relatively new member of their church and they dated about one year before discovering the pregnancy. They were on the path toward a committed relationship but they did not feel they were ready for marriage or co-parenting and abortion was not an option for them. Remi discussed the deep feeling of regret and sorrow about the pregnancy until the idea of a kinship adoption was introduced. Remi was aware of a family member who wanted to begin a family but had experienced multiple miscarriages. Remi (and later Dave) became open to exploring the idea of placing their child for adoption with another member of their family. And again, our partnership with local adoption agencies and specialists assisted Remi and Dave with their adoption plan and placement.

What we have discovered during our work with women in unplanned pregnancies who desire to consider an adoption placement is their need for extra support. Their profiles are different, their reasons for an adoption placement is different, but their need for women to advocate and promote the importance of their decision is the same. And it is vital! The common struggle of pregnant women considering adoption is respect for their choice from family, friends, religious communities and, most importantly, from women who chose to birth and rear their children, as well as, from women who wanted to terminate their pregnancy.

It is important for society to make every effort to support and recognize the thought provoking period associated with a pregnant women’s decision to place their child for adoption. Having support through the process is critical because of the level of grief experienced once the child is relinquished. Studies report women who chose to place their child for adoption experience a complicated form of grief because they “suffer the loss of a child although they are experiencing the psychological trauma and awareness that the child is alive.”

Adoption can be a loving choice. Most women who make the difficult choice to place their children for adoption do so because they love their child so much, they are willing to live apart to provide their child with a life they cannot provide at the present time.

The professional counselors and nurses at Support Circle are prepared to walk with an expectant woman considering adoption. We have relationships with Bay Area adoption agencies, specialist, and community organizations to assist women with their medical, emotional and psychological needs. We welcome the opportunity to serve you in one of our State licensed, medical clinics in the Bay Area. We also support the choice to place a child for adoption. It’s a selfless and courageous decision.

Sexually transmitted infections (STIs) or sexually transmitted diseases (STDs) are not fun or easy to talk about. It can be embarrassing to talk about STIs or STDs, but they are more common than you might realize. And, when it comes to pregnancy and STIs and STDs, it is best to learn about how to protect yourself from and treat STIs and STDs.

STIs and STDs are infections that are spread by having sex with someone that has a sexually transmitted infection. This could include oral, vaginal or anal intercourse. While STIs are common among men and women who are sexually active, many people do not know they have been infected. Some women may not find out that they have an STI until their first prenatal appointment when pregnant. Prenatal STI screening is standard because it is best to find out about an STI early in your pregnancy.

How do I know if I have an STI or STD?
At the first prenatal appointment, many women are tested (screened) for STIs including: chlamydia, gonorrhea, HIV, syphilis, Hepatitis B, and Hepatitis C. Testing may be done through blood tests, vaginal swabs and urine tests. If you suspect you might have an STI/STD, you should ask for testing. Testing is routinely done on pregnant women who are less than 25 years of age as well as those women that have new or multiple sexual partners, have a sexual partner that has other partners, past or current needle drug users, not in a monogamous relationship, no or sporadic condom use, a sexual partner that has an STI, sex workers, exchanging sex for drugs or money, and/or those living in high risk areas.

What happens if I have an STI or STD?
If you test positive, you will be notified by your healthcare professional in several days or about a week. Usually, immediate treatment with antibiotics can clear up an STI. A follow-up test in the third trimester may be performed, depending on your age or risk factors. In the case of HIV, on-going treatment for you and your baby will be required. With all STIs, the sooner treatment is started, the sooner the infection can be treated and reduce the incidence of passing the STI on to your baby.

Will my pregnancy be affected?
Early testing during the first trimester and follow up testing during the third trimester, as well as treatment if an STI has been detected, will have a major impact on the chance of you and your baby being affected. In most cases, early detection and treatment will resolve any potential complications.

If untested and/or untreated, sexually transmitted infections in pregnant women could cause problems during pregnancy such as: preterm labor, premature rupture of membranes, and low birth weight. The infant could contract the STI during the pregnancy, during vaginal delivery, or after birth through breastfeeding, such in the case of HIV. Some STIs could have lifelong implications for your child. For these reasons, we strongly encourage women to have STI testing early in their pregnancy and to follow recommended treatment protocol(s).

Women who want to know more about STIs/STDs in pregnancy are welcome to talk to the team at Support Circle. Our caring staff will maintain your confidentiality while addressing your most pressing questions and can provide a list of clinics that provide STI/STD testing. We have three Bay Area clinics in San Francisco, Oakland and Redwood City for your convenience. Call or walk-in today.

Are you feeling nervous, unprepared, or afraid of telling your parents that you are pregnant? It’s easy to share news we know for sure our parents will be excited about. But other times, we are not sure how they will take what we have to share. Telling parents that you are in an unplanned pregnancy brings its own range of angst. Here are nine areas to think about when preparing to tell your parents that you are pregnant.

Get the Facts

Before you tell your parents and before you get too stressed out, confirm that you are pregnant. The nurses at Support Circle can perform a pregnancy test for you to confirm the results of a home pregnancy test that you may have purchased at a CVS pharmacy or a Walgreens pharmacy.

If it turns out that you are not pregnant, you won’t have to have this difficult conversation with your parents. If you plan to remain sexually active, selecting a reliable birth control plan can help you to avoid facing an unplanned pregnancy. If you are pregnant, a Support Circle nurse can perform a free ultrasound that will tell you how far along you are and can determine if the fetus is viable. If the fetus is not viable, it will drastically change your decision making process and what conversation, if any, you might decide to have with your parents.

Know Your Parents

Think back to how your parents react to sudden news. Are they calm and rational? Do they freak out and then calm down and think it through? How your parents react will be determined by their personalities and also by factors including these questions you should answer ahead of time: Are they aware that you are dating? Do they know you have been sexually active? How old are you? Do they perceive you to be mature for your age? Are you in school, working or both? What expectations do they have for you? What are their values regarding dating and sex? Have your parents experienced an unplanned pregnancy? Knowing what to expect from your parents can help you to prepare for their reaction. Ultimately, you will not know how your parents will react until you tell them. The next steps will help you to prepare to tell your parents you are pregnant.

Expert Support

What do you want to do about your pregnancy? In your perfect world, would you want to abort, place for adoption or parent? Regardless of your decision, you should talk to a professional pregnancy counselor because she can help you to determine your next steps. Pregnancy counselors have the knowledge of and access to community resources that you may need. They have lots of experience and can answer your questions. Caring counselors are able to give you the emotional support you need to make your best decision and throughout your pregnancy and beyond. If you decide you want to talk to your parents, a counselor can help you to role play the conversation and create a plan for how to discuss different topics with them. Many women have found this to be very helpful prior to approaching their parents.

A Support System

You will need support from those closest to you. It will help to have someone in your life that you can talk to. Someone who can help you to process your thoughts, values, emotions, and options. Often, a wise support person may be a close family friend, school counselor, favorite teacher, aunt or uncle.

Make a Plan

Having a plan for your next steps, based on your pregnancy decision, will show your parents that you have given this thought. If you are younger, it will help them to see that you have begun to take a mature approach to your pregnancy. You do not have to have every area outlined or thought out – they can help with that. A trusted advisor or pregnancy counselor can help you to lay out a plan based on your decision. It would also be a good idea to have a plan ready in case your parents request that you leave your home or emergency shelter if your home becomes a dangerous place for you.

Bring a Friend

Ideally, you and your boyfriend or girlfriend should tell your parents together. Sometimes, that is not possible. The next best option is to bring a friend. If you are concerned about your parents’ reaction or need help telling them, it might be wise to bring a friend. The person you selected as part of your support system might be a good choice. If you are concerned about your safety, having a friend present could help to diffuse the situation. Or, you could meet with your parents in a counselor’s office. A professional pregnancy counselor can address your parents’ questions and concerns as well as provide valuable resources for your family.

The Best Time

There really is no “best time” to tell your parents about your unplanned pregnancy. However, there are “better times.” Right after work, as soon as your parents walk in the door is not the best time. A better time would be after dinner or after a younger sibling has gone to bed. Consider your parents’ schedules and select a time when they will be most relaxed and receptive to a conversation.

What to Say

Your plan will help you to know what you need to share with your parents. For example, if you are younger, or still under their medical insurance, you may need their consent for medication or procedures, or help navigating medical bills. Do you need a ride to/from medical appointments or financial support? A clear and concise: “Mom, Dad, I’m pregnant,” will certainly get the conversation rolling. Chances are, your parents will do much of the talking and asking questions after an opening line like above.

Give it Time

This is life-changing news. It took you some time to come to terms with your pregnancy. Allow your parents time to process this information and come to terms with your pregnancy as well. Just as you went through a range of emotions, your parents may as well. They have to grieve the expectations and plans they had envisioned for you and accept the new reality. Be patient.

What you do with your pregnancy is your decision to make. Hopefully, your parents will support you in your decision. If not, we hope the tips shared above will help you to have a plan and support system in place.

The caring and supportive nurses and counselors at Support Circle are available to help you with pregnancy testing, counseling during your decision process and on-going counseling and support for the coming year after your decision. We have three locations in the Bay Area including Redwood City, San Francisco and Oakland that offer services free of charge. You do not have to walk through this journey alone. Connect with us today and let us help you find the information you are looking for.

If you are reading this article, you may be pregnant and considering an abortion. Most women do not come to the decision to abort lightly. You may be concerned about your school or employment, housing, what your family will say, finances, etc. According to a recent Public Opinions survey, one of the biggest factors in women deciding on abortion is the relationship with the father. Women contemplating an abortion are often in most need of their friends, family, partner. Sadly, this may feel like a very lonely time for you. Whatever your reasons for considering abortion, at Support Circle, we are able to provide you with a caring, listening, non-judgmental counselor that can help you through this time and even in the months following your pregnancy decision.

Before going any further, first things first. Have you confirmed your pregnancy by visiting a medical office or clinic? Medical pregnancy tests can be more accurate than home pregnancy tests purchased at your local CVS or Walgreens pharmacy. After confirming your pregnancy, you may choose to have an ultrasound performed. Why? Ultrasounds are able to provide accurate dating of your pregnancy. This is important because your options are determined by how far along in the pregnancy you are. And, an ultrasound can go one step further to see if this is an ectopic pregnancy. Ectopic pregnancies are usually treatable with medication if discovered early but can be potentially life-threatening.

Medical Abortion

If the pregnancy is less than ten weeks from the date of your last menstrual cycle, you may be eligible for a medical abortion, also known as the Abortion Pill. Medical abortions are performed using two different drugs while under the supervision of a doctor, nurse practitioner, or midwife. The Abortion Pill is a drug called Mifepristone, Mifeprex, or RU486 and is available by prescription only. Mifepristone, when used in combination with Misoprostol, disrupts an existing pregnancy. Typically, during the initial medical visit, you will be asked to complete blood tests, an ultrasound and counseling prior to beginning the drug regimen.

The two-part drug regimen can only be obtained with a prescription. The first drug makes the uterus a difficult place for the fetus to remain implanted. The second drug helps to remove the fetus from the uterus. In technical terms, Mifepristone is an anti-progesterone that causes the lining of the uterine walls to shed and it softens and dilates (expands) the cervix, thus facilitating an abortion. Misoprostol, the second drug, is a prostaglandin that induces uterine contractions and softens and dilates the cervix. It is taken approximately 48 hours after taking Mifepristone. When these two drugs are taken in combination with each other, a medical abortion is complete approximately 97% of the time. A follow up visit 7-14 days later is very important to ensure there is no tissue left behind and that the abortion occurred successfully.

Some women experience mild cramping and/or nausea in addition to vaginal bleeding or spotting. The most common side effects of the Mifepristone and Misoprostol regimen include: pelvic cramping, vaginal bleeding, and spotting (including the expelling of tissue and blood clots) for an average of 9-16 days. It is also common to experience nausea, vomiting, dizziness, headaches, fever, chills, weakness and diarrhea. Contact your medical practitioner if you are concerned about the side affects you are experiencing.

Surgical Abortion

Depending upon how far your pregnancy has progressed, there may be two kinds of surgical abortion options available to you. Aspiration (also known as vacuum aspiration or suction curettage) can be performed up to 12-14 weeks after the start of the last menstrual cycle. It only requires one visit to a medical clinic. Typically, during that visit, you will be asked to complete blood tests, an ultrasound and counseling prior to the procedure.A local anesthesia will be applied to the cervix to numb pain. You might feel some minor pressure but should not feel pain. The cervix is dilated (expanded) and the aspiration device empties the contents of the uterus. While the aspiration procedure only takes approximately 5-15 minutes, you will need to recover for about 30 minutes afterward.

For pregnancies from 13-24 weeks after the start of your last menstrual cycle, a Dilation and Evacuation (D&E) is the surgical abortion procedure available. A D&E is similar to the aspiration abortion. However, the cervix is dilated more and this procedure requires two or three visits. For the first appointment, blood tests, an ultrasound and counseling session are standard. Also on the first visit, either medication or fiber rods are used to begin to dilate the cervix. On the next visit, if your cervix is sufficiently dilated, the same aspiration device is used to empty the uterus. Additional instruments may be used to ensure the contents of the uterus are fully cleared. A local anesthetic to numb the pain and make you semi-conscious is often used. Sometimes, a general anesthetic may be used to put you to sleep, depending upon the medical facility. The D&E procedure is usually 10-45 minutes with at least one hour of recovery time afterwards.

Deciding to abort a pregnancy is seldom a decision made lightly. No one should pressure you into making a decision about your pregnancy. This includes the father, family, friends, counselors, etc. And sometimes, the greatest pressure comes from ourselves. If you would like to talk to someone about your decision, thoughts, emotions, or ask medical questions at any time, the caring counselors at Support Circle are available to listen and to provide non-judgmental emotional support before and after the pregnancy decision for the coming year. Our nurses can confirm your pregnancy test results, provide you with pregnancy verification and assist with dating the pregnancy during an ultrasound.

Call or visit one of our three medical clinics in San Francisco, Oakland and Redwood City. All appointments are confidential and free of charge.

Support Circle is dedicated to providing women with a safe place as they make a decision about their pregnancy and not to profit from any medical procedures resulting from that decision. For this reason, Support Circle provides information about abortion procedures to our clients, but does not perform or refer for abortion. We do not operate as an adoption agency. We do not perform or refer for labor and delivery.

An “ectopic pregnancy” occurs when the fertilized embryo implants outside of the uterus; most commonly in fallopian tube. When attached to the fallopian tube, this is referred to as a “tubal pregnancy.” Approximately 16%1 of women seeking emergency medical attention due to cramping and/or vaginal bleeding in the first trimester are diagnosed as having an ectopic pregnancy. Overall, ectopic pregnancies are rare, occurring in 1%-2%2 of all pregnancies. As the embryo grows, it can cause the tube to rupture (burst), which can cause major internal bleeding. This can be life threatening3 and/or cause future fertility issues if not discovered early.

Bleeding and cramping are the most common symptoms of an ectopic or tubal pregnancy. Women who are pregnant or may be pregnant should seek immediate medical attention for a possible ectopic pregnancy if they experience any or all of the following symptoms:

Cramping pain in the lower abdomen that may worsen with coughing, moving, or bowel strain

Sharp, steady pelvic pain

Vaginal bleeding

Nausea and vomiting

Dizziness or weakness

Shoulder pain

Feeling of pressure in the rectum

Risk factors leading to a greater risk for an ectopic pregnancy include: previous tubal surgery, sterilization, previous ectopic pregnancy, current use of an intrauterine device (IUD), history of pelvic inflammatory disease (PID), infertility for two years or longer, women over the age of 35 years, and smoking.

When a pregnant patient presents with first-trimester bleeding or abdominal pain, physicians should consider ectopic pregnancy as a possible cause. The patient history, physical examination and imaging with transvaginal ultrasound can usually confirm the diagnosis. In some cases, a blood test may also be used to determine diagnosis.2 The ultrasound is performed to check where the embryo implanted, if not found in the uterus. An ultrasound is one of the best methods to determine where the embryo may have implanted and alert if there are other health concerns to be aware of.

Since ectopic pregnancies may be life threatening, they must be treated as an emergency situation and the doctor will determine how best to end the pregnancy, as the embryo cannot be transplanted into the uterus. Many cases of ectopic pregnancy, if caught early enough, can be treated with medicine and not surgery. Early detection may help preserve the fallopian tube for future pregnancy attempts.

In all cases of suspected tubal pregnancies, the Support Circle technician or nurse will immediately refer the woman to the emergency room. If you have questions, Support Circle staff at our three Bay Area clinics are available.

Is your period late? Do you think you may be pregnant? Pregnancy symptoms differ from woman to woman and pregnancy to pregnancy. Understanding the signs and symptoms of pregnancy is important because each symptom may be related to something other than pregnancy. If you think you may be pregnant, treat yourself as if you are until you know otherwise.

Some women experience pregnancy signs or symptoms of pregnancy within a week of conception. For other women, pregnancy symptoms may develop over a few weeks or may not be present at all. Below is a listing of some of the most common pregnancy signs symptoms. If you have been sexually active and are experiencing any of the following symptoms, it is recommended to take a pregnancy test.

Early Symptoms of Pregnancy:

Spotting and Cramping – A few days after conception, the fertilized egg travels and attaches itself to the wall of your uterus, causing implantation bleeding, one of the earliest signs of pregnancy. This may occur around six to 12 days after fertilization.

Nausea or Morning Sickness – Is one of the most common and popular pregnancy symptoms, but not all women experience it. Nausea can occur at any time of day and not just in the morning. The cause of morning sickness or nausea is likely to be hormonal changes.

Missed/Delayed Period – Is the most obvious symptom of pregnancy, and the one that prompts most women to visit our free clinic for a pregnancy test. However, a missed period could be caused by other things besides pregnancy. It may be a symptom of hormonal problems caused by fatigue or stress. It may also be a side effect of taking oral contraceptives.

Hormonal changes are likely to be the cause of other early pregnancy symptoms including:

Difference in menstruation

Fatigue/Tiredness

Frequent urination

Headaches

Dizziness

Food cravings and aversions

Back pain

Mood swings

However, these signs and symptoms are not exclusive to pregnancy. These signs and symptoms could indicate that you are about to get sick. They could also indicate that your period is coming soon. In some women, pregnancy can occur without any of the later signs and symptoms of pregnancy. In addition, there might be other pregnancy symptoms that could happen to you that are not commonly experienced.

If you have missed a period or suspect that you may be pregnant, you might want to get a pregnancy test. The licensed health professionals at each of our three Bay Area Support Circle Clinics can administer a pregnancy test for you. Whether your test comes back negative or positive for pregnancy, our health professionals can discuss possible reasons for your symptoms, or pregnancy options, and guide you through next steps. Support Circle’s confidential services are offered free of charge.